School Facility Dog Workshop

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Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Your position or title(Required)

What grades do you work with?(Required)

School Name and District(Required)

Dog Name (if applicable)

Do you have any dietary restrictions? Please describe.

What topics are you most interested in learning about?

Are you currently…

an active SFD handler

on the SFD waitlist

interested in learning more about SFDs

Will you be register with Credit Card or Check?(Required)

Credit Card

Check

Registration cost is $25.00

Please make checks payable to THE ABILITY CENTER and mail to The Ability Center, 5605 Monroe St., Sylvania, OH 43560

Your registration is not complete until payment is received.

Registration Cost

Price:

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name